Heart failure with preserved ejection fraction: Chronic low-intensity interval exercise training preserves myocardial O2 balance and diastolic function

Kurt D. Marshall, Brittany N. Muller, Maike Krenz, Laurin M. Hanft, Kerry S. McDonald, Kevin C Dellsperger, Craig A. Emter

Research output: Contribution to journalArticle

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Abstract

Heart failure with preserved ejection fraction: chronic low-intensity interval exercise training preserves myocardial O2 balance and diastolic function. J Appl Physiol 114: 131-147, 2013. First published October 25, 2012; doi:10.1152/japplphysiol.01059.2012.-We have previously reported chronic low-intensity interval exercise training attenuates fibrosis, impaired cardiac mitochondrial function, and coronary vascular dysfunction in miniature swine with left ventricular (LV) hypertrophy (Emter CA, Baines CP. Am J Physiol Heart Circ Physiol 299: H1348-H1356, 2010; Emter CA, et al. Am J Physiol Heart Circ Physiol 301: H1687- H1694, 2011). The purpose of this study was to test two hypotheses: 1) chronic low-intensity interval training preserves normal myocardial oxygen supply/demand balance; and 2) training-dependent attenuation of LV fibrotic remodeling improves diastolic function in aortic-banded sedentary, exercise-trained (HF-TR), and control sedentary male Yucatan miniature swine displaying symptoms of heart failure with preserved ejection fraction. Pressure-volume loops, coronary blood flow, and twodimensional speckle tracking ultrasound were utilized in vivo under conditions of increasing peripheral mean arterial pressure and β-adrenergic stimulation 6 mo postsurgery to evaluate cardiac function. Normal diastolic function in HF-TR animals was characterized by prevention of increased time constant of isovolumic relaxation, normal LV untwisting rate, and enhanced apical circumferential and radial strain rate. Reduced fibrosis, normal matrix metalloproteinase-2 and tissue inhibitors of metalloproteinase- 4 mRNA expression, and increased collagen III isoform mRNA levels (P < 0.05) accompanied improved diastolic function following chronic training. Exercise-dependent improvements in coronary blood flow for a given myocardial oxygen consumption (P < 0.05) and cardiac efficiency (stroke work to myocardial oxygen consumption, P < 0.05) were associated with preserved contractile reserve. LV hypertrophy in HF-TR animals was associated with increased activation of Akt and preservation of activated JNK/SAPK. In conclusion, chronic lowintensity interval exercise training attenuates diastolic impairment by promoting compliant extracellular matrix fibrotic components and preserving extracellular matrix regulatory mechanisms, preserves myocardial oxygen balance, and promotes a physiological molecular hypertrophic signaling phenotype in a large animal model resembling heart failure with preserved ejection fraction.

Original languageEnglish (US)
Pages (from-to)131-147
Number of pages17
JournalJournal of Applied Physiology
Volume114
Issue number1
DOIs
StatePublished - Jan 1 2013

Fingerprint

Miniature Swine
Heart Failure
Left Ventricular Hypertrophy
Exercise
Oxygen Consumption
Extracellular Matrix
Fibrosis
Oxygen
RNA Isoforms
Ventricular Remodeling
Matrix Metalloproteinase Inhibitors
Matrix Metalloproteinase 2
Adrenergic Agents
Blood Vessels
Arterial Pressure
Collagen
Animal Models
Stroke
Phenotype
Pressure

Keywords

  • Coronary flow
  • Diastolic heart failure
  • Exercise
  • Fibrosis
  • Hypertrophic signaling
  • MVO
  • Speckle tracking

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Heart failure with preserved ejection fraction : Chronic low-intensity interval exercise training preserves myocardial O2 balance and diastolic function. / Marshall, Kurt D.; Muller, Brittany N.; Krenz, Maike; Hanft, Laurin M.; McDonald, Kerry S.; Dellsperger, Kevin C; Emter, Craig A.

In: Journal of Applied Physiology, Vol. 114, No. 1, 01.01.2013, p. 131-147.

Research output: Contribution to journalArticle

Marshall, Kurt D. ; Muller, Brittany N. ; Krenz, Maike ; Hanft, Laurin M. ; McDonald, Kerry S. ; Dellsperger, Kevin C ; Emter, Craig A. / Heart failure with preserved ejection fraction : Chronic low-intensity interval exercise training preserves myocardial O2 balance and diastolic function. In: Journal of Applied Physiology. 2013 ; Vol. 114, No. 1. pp. 131-147.
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KW - Coronary flow

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KW - Hypertrophic signaling

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